Evidence mapPaperPMID 41984206Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

High-potency statins are associated with reduced osteoporosis but increased fracture risk in CKD patients: a multi-center retrospective study.

Ping-Hsun Wu, Yi-Ting Lin, Jian-Chih Chen, Sung-Yen Lin, Li-Ting Kao, Yu-Ting Huang, Pei-Shan Ho, Chung-Hwan Chen, Tien-Ching Lee

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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5 · Who and what money

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9 authors.

Ping-Hsun WuDivision of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yi-Ting LinCenter, for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
Jian-Chih ChenDepartment of Orthopedics, College of Medicine, Division of Sports Medicine and Orthopaedic Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1 Road, Kaohsiung, 80708, Taiwan.
Sung-Yen LinDepartment of Orthopedics, College of Medicine, Division of Sports Medicine and Orthopaedic Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1 Road, Kaohsiung, 80708, Taiwan.
Li-Ting KaoRegenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
Yu-Ting HuangDivision of Medical Statistics and Bioinformatics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Pei-Shan HoFaculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chung-Hwan ChenDepartment of Orthopedics, College of Medicine, Division of Sports Medicine and Orthopaedic Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1 Road, Kaohsiung, 80708, Taiwan.
Tien-Ching LeeDepartment of Orthopedics, College of Medicine, Division of Sports Medicine and Orthopaedic Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1 Road, Kaohsiung, 80708, Taiwan. tn916943@gmail.com.ORCID http://orcid.org/0000-0002-1510-8079

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic kidney disease patients face increased osteoporosis and fracture risk. High-potency statins were associated with lower osteoporosis incidence but also with higher long-term fracture incidence in this observational study. These findings highlight the need for tailored statin use and proactive fracture monitoring in CKD populations for optimal bone health management. PURPOSE: Chronic kidney disease (CKD) affects approximately 850 million people worldwide and is associated with increased risks of cardiovascular events and fractures. The differential effects of statin potency on bone health in CKD patients remain incompletely understood.

methodsThis retrospective cohort study used the TriNetX US Collaborative Network to identify adults with CKD stages 3 or 4 initiating statin therapy, categorized into high-potency (atorvastatin 40-80 mg, rosuvastatin 20-40 mg) and low-potency groups. After 1:1 propensity score matching, three primary outcomes were evaluated: new osteoporosis diagnosis, anti-osteoporotic medication initiation, and incident fractures, assessed at 3-12 months and beyond 12 months. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox and competing risk regression models.

resultsAmong 873,180 matched patients, high-potency statins were associated with a 20.0% reduction in osteoporosis diagnosis (HR 0.80; 95% CI 0.78-0.82) and 24.9% fewer anti-osteoporotic medication prescriptions (HR 0.75; 95% CI 0.73-0.78) during 3-12 months, with associations persisting beyond 12 months. Fracture risk did not differ at 3-12 months (HR 0.99; 95% CI 0.96-1.02); but increased beyond 12 months (HR 1.13; 95% CI 1.11-1.15).

conclusionsHigh-potency statins are associated with lower osteoporosis diagnosis rates and fewer anti-osteoporotic medication prescriptions in CKD stages 3 and 4. The increased long-term fracture risk may reflect a diagnostic gap wherein lower osteoporosis detection contributes to under-treatment of bone fragility. Prospective randomized controlled trials with bone-specific endpoints are warranted to confirm these findings.

Indexed as

Chronic kidney diseaseFracture riskHigh-potency statinsOsteoporosisPropensity score matchingStatins

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.